The first few weeks following amputative surgery is a critical time for the amputee, both physically and emotionally. It is important during this period of time for the residual stump to be therapeutically compressed circumferentially so as to reduce the size and swelling of the stump from edema in preparation for fitting with a prosthesis.
It is also important, however, that the compressive force be carefully and properly applied in the sense that there must be greater pressure at the distal end of the stump than its upper or proximal end, since the opposite condition would have a tourniquet effect and prevent the vascular return of liquid upwardly through the stump toward the heart. Yet, the stump is also extremely sensitive at this time, and thus extreme care must be taken to avoid excessive compression or other irritation of the stump.
Accordingly, various types of stretchable, sock-like stump shrinkers have heretofore been provided in an effort to meet these needs. Such shrinkers have taken a variety of forms but have also presented a number of drawbacks.
For example, some shrinkers are simply constructed from two pieces of stretchable cloth material laid on top of one another and sewn together along their sides and across the toe so as to present a socket for the stump. However, this construction also produces distinct and bulky seams which can be quite irritating and uncomfortable to the patient, especially across the toe where the wound itself is located.
Others have been knitted on circular knitting machines so as to present a continuous, tubelike construction and thereby avoid the presence of longitudinal side seams. However, even in these shrinkers, the closure at the toe end is in the form of a separate circular pad or simply a sewn closed toe which must be sewn in place, or fabric (also called end cap), thereby presenting a rather thick, irritating seam at that location.
In some prior shrinkers the therapeutic compression is achieved by strands of elastic that encircle the shrinker. However, with that type of construction, the compression tends to vary dramatically depending upon the degree of stretch, since the elastic strands are simply being tensioned axially to greater and greater extents as the shrinker is stretched by insertion of the stump. In other words, depending upon the degree of stretch involved, the compressive snugness of the shrinker using the straight elastic strands will vary over a wide range, sometimes being too loose at the low end of the range where the stump is somewhat undersized and too high at the upper end of the range where the stump may be larger because of its shape. This can be a particular problem where the stump is irregularly shaped, since due to its irregularity, the stump may not cause the shrinker to be stretched to the point at which optimum therapeutic compression occurs, or, on the other hand, it may cause the shrinker to stretch so much at the point of irregularity that excessive compression occurs.